Long-term Follow-up of Positive Surgical Margins in Basal Cell Carcinoma of the Face

Abstract

Patients with superficial multifocal or micronodular tumors should undergo reoperation because of high recurrence rates.

S2k Guidelines for Cutaneous Basal Cell Carcinoma – Part 2: Treatment, Prevention and Follow‐up

“…Conventional surgery has been reported to result in incomplete excisions in 4.7 % to 24 % of all surgically removed tumors; however, recurrence must be expected in only 26 % to 41 % of BCC lesions following incomplete excision. Moreover, approximately one‐half of the specimens contain no residual tumor tissue following re‐excision . There are, however, no reliable predictive indicators and recurrent tumors may exhibit a more aggressive growth pattern after incomplete excision .…”

“…Accordingly, re‐excision shall be performed after incomplete surgical removal (R1 resection). In the event of high‐risk tumors or lesions in critical sites as well as deep recurrences, re‐excision should be preferably performed as microscopically controlled surgery to ensure complete tumor clearance . Alternatively, radiation therapy may be used for incompletely resected high‐risk BCCs, especially if there are factors that complicate a subsequent surgical procedure (extent of the re‐excision, comorbidity).…”

Superficial basal cell carcinoma: A comparison of superficial only subtype with superficial combined with other subtypes by age, sex and anatomic site in 3150 cases

“…Additional other BCC subtypes can display infiltrative tumor architecture that with time may progress to invade deeper into the reticular dermis and even beyond . Infiltrating, morpheic or sclerosing and to a lesser extent micronodular BCC subtypes are prone to more aggressive behavior typically requiring more aggressive surgical intervention or radiotherapy in selected patients. In contrast, sBCC has the characteristic histopathology of a thin tumor hugging the under‐surface of the dermoepidermal junction and projects down into the papillary dermis.…”

Defect Reconstruction of the Nose After Surgery for Nonmelanoma Skin Cancer: Our Clinical Experience

“…They reported a 33% recurrence in patients with a positive surgical margin. In addition, in another study, the recurrence rate increased up to 26% in patients with positive surgical margins (28). Further, Stratigos et al (29) reported that in cutaneous SCC, the minimal surgical excision margins should be five-mm, even in low-risk tumors.…”